Individual
COLETTE MAUREEN BISANZ-HAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
9301 BRYANT AVE S STE 107, BLOOMINGTON, MN 55420-3438
(952) 562-3740
(952) 405-9723
Mailing address
9301 BRYANT AVE S, BLOOMINGTON, MN 55420-3436
(952) 562-3740
(952) 405-9723
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1077449-2CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
472356918
—
MN
Enumeration date
03/11/2016
Last updated
03/11/2016
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